Subject(s)
Anti-Bacterial Agents/administration & dosage , Liver Abscess/drug therapy , Adolescent , Adult , Aged , Drug Therapy, Combination , Female , Humans , Liver Abscess/diagnosis , Liver Abscess/surgery , Male , Metronidazole/administration & dosage , Middle Aged , Suppuration , UltrasonographyABSTRACT
The efficacy and toxicity of netilmicin was assessed in 15 patients with life-threatening infections, including six with septicaemia. Fourteen patients were cured with no recurrence of infection. The initial dosage of netilmicin was 200 mg twice a day (2.3-4.0 mg/kg/dose), but subsequent adjustment of dosage was made according to the results of serum assay, either to avoid accumulation or to improve therapeutic response. Probable nephrotoxicity occurred in only one patient and there was no evidence of ototoxicity in the twelve patients who could be assessed.
Subject(s)
Bacterial Infections/drug therapy , Gentamicins/administration & dosage , Netilmicin/administration & dosage , Adult , Aged , Creatinine/blood , Drug Evaluation , Enterobacteriaceae Infections/drug therapy , Female , Hearing/drug effects , Humans , Kidney/drug effects , Male , Middle Aged , Netilmicin/adverse effects , Netilmicin/blood , Pseudomonas Infections/drug therapy , Staphylococcal Infections/drug therapyABSTRACT
Twenty patients with severely impaired renal function, 17 of wnom had recently transplanted kidneys, were treated with aminoglycosides for severe infections acquired in hospital. Serum aminoglycoside concentrations were closely monitored and dosages adjusted individually to obtain peak and trough concentrations that ensured adequate treatment while avoiding toxicity. Causative organisms were susceptible to treatment in 21 out of 26 episodes of infection (81%), and 12 of the 17 patients (71%) in whom organisms were isolated were cured. Nephrotoxicity attributable to aminoglycosides alone was not observed during the 35 courses of treatment. Ototoxicity occurred in only one patient, who had excessively high serum concentrations of amikacin. Serum aminoglycoside concentrations were directly affected by carbenicillin and flucytosine. The concurrent administration of cephradine and cephalexin with gentamicin may have produced nephrotoxicity. We conclude that aminoglycosides, when carefully monitored, are effective and safe in patients with severely impaired renal function.
